Standard Research Grant: Science and the Social Production of Crisis: Sagas of HIV/Blood Contamination

1980年代初，所有工业化国家都发生了血液供应中的艾滋病毒污染。从感染人数和死亡率来看，由此在不同国家发生的医疗灾难的范围几乎是不可想象的。不同国家在艾滋病流行的起因和进程上面临同样的科学不确定性，在关键行为者(即血液银行家、政府卫生官员、立法者、好战的血友病患者)和在确定体制失误方面存在明显重叠。然而，这种情况在一些国家从未上升到政治危机的程度，但在另一些国家却上升到了政治危机的程度。这个项目的目标是了解历史、政治、科学、医学和公共卫生是如何融合在一起，在某些社会背景下将健康灾难转变为政治危机，而不是在其他社会背景下。对对同一公共卫生灾难有不同反应的国家的详细比较提供了一个自然的实验，以揭示意识形态、制度结构和社会运动组织在将灾难政治化或减轻灾难方面的重要性。在我们全球化的世界里，公共卫生灾难已经成为生活中的一个事实，政府和公众对此的不同反应也是如此。最近的新冠肺炎大流行只是一个很好的例子。该项目将为博物馆和图书馆制作播客和展览，教育公众有关这些问题。该项目的基础是对以前无法获取的政府文件进行的历史和档案研究，以及与艾滋病疫情主要参与者的口述历史。在世界各国，血液作为人类尊严和人格完整性固有的体液的含义，作为一种类似于阿司匹林或青霉素的畅销药物，或作为一种医疗服务，如器官移植，以及将这些含义制度化的血液系统的组织，都在第二次世界大战结束时到位。自战争以来的几十年里，这些系统在不同国家之间的不同演变以及围绕它们的截然不同的意识形态的演变，是理解它们对艾滋病毒血液污染的不同反应的关键。这种系统性差异导致在对科学不确定性的解释和管理、科学和/或公共卫生管理不善的责任归属以及缓解战略方面形成鲜明对比。总体而言，这个项目将有助于我们了解在什么情况下公共卫生灾难也可能成为政治危机。这个奖项反映了NSF的法定使命，并通过使用基金会的智力优势和更广泛的影响审查标准进行评估，被认为值得支持。

HIV contamination of the blood supply happened in all industrialized countries in the early 1980s. The scope of the consequent medical disaster in different nations was almost unimaginable in terms of the numbers infected and mortality. Different countries confronted the same scientific uncertainties on the etiology and course of the AIDS epidemic, and there was marked overlap in key actors (i.e. blood bankers, government health officials, legislators, militant hemophiliacs) and in the identification of institutional failures. Nevertheless, this occurrence never rose to the level of political crisis in some nations but did in others. The goal of this project is to understand how history, politics, science, medicine, and public health converge to transform health catastrophes into political crises in some social contexts but not others. A detailed comparison of countries with different responses to the same public health disaster offers a natural experiment to unravel the importance of ideology, institutional structures, and social movement organizations in politicizing or mitigating catastrophe. Public health disasters have become a fact of life in our globalized world, as have differential governmental and public responses to them. The recent COVID-19 pandemic is but one case in point. The project will produce a podcast and an exhibition for museums and libraries to educate the public about these issues.This project is grounded in historical and archival research into previously inaccessible government documents, and in oral histories with major players in the AIDs epidemic. Across nations, the meanings of blood as a bodily fluid intrinsic to human dignity and personal integrity, as a marketable drug akin to aspirin or penicillin, or as a medical service like an organ transplant, and the organization of blood systems that institutionalize these meanings, were put in place at the end of the second world war. The differential evolution of these systems across nations over the decades since the war and of the starkly different ideologies surrounding them are key to understanding their different responses to HIV blood contamination. Such systemic differences lead to marked contrasts in interpretation and management of scientific uncertainties, in attributions of responsibility for scientific and/or public health mismanagement, and in strategies of mitigation. Overall, this project will contribute to our knowledge of the circumstances under which public health disasters are likely to also become political crises.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.